Epidemiology

is the study of the distribution and determinants of disease in a population. Public health epidemiologists monitor the health and illness of a population, investigate the factors that affect the community's health, and recommend interventions to reduce the risk of disease. Epidemiology is practiced in health departments daily and involves principles of surveillance, investigation, laboratory testing, data management and communication.

Measles - Multi-state Outbreak Update

February 2015

The United States is currently experiencing a large, multi-state outbreak of measles linked to an amusement park in California. From January 1 to February 6, 2015, 121 people from 17 states in the U.S. have been reported with measles. Most of these cases are part of a large, ongoing outbreak linked to an amusement park in California. To date, there have been no reported cases of measles in Virginia this year.

The outbreak likely started from a traveler who became infected overseas with measles, then visited the amusement park while infectious. However, no source has been identified. For current details on the outbreak, visit the CDC Measles Multi-state Outbreak webpage.

Between 2009 and 2014, 13 cases of measleswere reported in Virginia. Six of these individuals were unvaccinated (three of whom were too young to receive vaccine), five were not fully vaccinated, and two were fully vaccinated. In Virginia, 88.6 percent of children have received the measles vaccine by their second birthday and 93.1 percent are fully vaccinated against measles when they begin school.

Measles is highly infectious, but it is also highly preventable through vaccination. The Virginia Department of Health urges persons who are not vaccinated or whose children have not been vaccinated, to receive vaccine as soon as possible. You may receive vaccine from your doctor or local health department. Virginia Code allows for exemption from required immunizations for religious and/or medical reasons; however, exemption rates remain low at 0.19 percent for medical and 0.84 percent for religious reasons.

Online Resources

Office of Epidemiology
Home page for VDH’s Office of Epidemiology. It will connect you with the Divisions of Surveillance and Investigation, Disease Prevention, Environmental Epidemiology, Immunization and Radiological Health.

Disease Regulation Information
Contains the complete regulations for disease reporting and control for Virginia. You will also find the reportable disease list, conditions reportable by laboratories, outbreak reporting requirements and the reporting form (Epi-1).

Disease Fact Sheets
Contains all of VDH's disease fact sheets. From head lice to whooping cough to West Nile Virus, this is the first stop for quick, reliable disease information. Fact sheets are also available here in Spanish.

Nursing Facility RegulationsContains a line list of guidelines from VDH’s Office of Licensure and Certification. The Rules and Regulations for the Licensure of Nursing Facilities in Virginia can be found here.

Successful Strategies for Infection Prevention & ControlThis toolkit contains infection prevention presentations, resources, and tools that have been adapted for the assisted living facility (ALF) and nursing home (NH) setting whenever possible. Much of the tools like infection prevention guidance, fact sheets and surveillance logs, however, are generally applicable to other settings.

Ebola Outbreak in West Africa

Current Situation
The countries of Guinea, Sierra Leone, and Liberia continue to experience an outbreak of Ebola. For the most up-to-date information, including case counts, visit the CDC Ebola Outbreak webpage.

Airport entrance screening of travelers from Ebola-affected countries entering the United States. Travelers are evaluated for symptoms and risk of Ebola exposure.

Post-arrival 21 day monitoring of all travelers from Ebola-affected countries entering the United States. Travelers from Guinea, Sierra Leone, Liberia, and Mali are monitored for 21 days by public health authorities.

What is Ebola?
Ebola hemorrhagic fever is one of several Viral Hemorrhagic Fevers. It a rare and deadly disease caused by one of the Ebola virus strains. People who become infected typically develop fever, headache, weakness, joint and muscle aches, diarrhea, vomiting, stomach pain, and loss of appetite. Some people may also begin to hemorrhage (bleed) inside and outside of the body. It is spread by direct contact (through broken skin or mucous membranes) with an infected person’s blood or body fluids, such as urine, saliva, feces, vomit, and semen. It is also spread through contact with objects (like needles) that have been contaminated with infected secretions. For more information, see the CDC Ebola fact sheet.

Risk in the U.S.
Transmission of the virus requires direct contact with an infected person’s blood or body fluids or contact with objects contaminated with infected secretions. Therefore, there is no significant risk for widespread transmission in the U.S.

Healthcare providers in the U.S.
CDC encourages all U.S. healthcare providers to

Take good travel histories of their patients to determine if they have traveled to Guinea, Sierra Leone, Liberia or Mali within the last 3 weeks.

Know the symptoms of Ebola—fever, headache, joint and muscle aches, weakness, diarrhea, vomiting, stomach pain and lack of appetite, and in some cases bleeding.

For symptomatic patients with recent travel to Guinea, Sierra Leone, Liberia or Mali or contact with a known case, isolate the patient properly, then follow infection control precautions to prevent spread.

Contact your local health department to discuss any suspected case and testing.

As of the week ending November 22nd, the threshold was surpassed, with 11.1% of ED/urgent care visits being due to GI illness. In reviewing outbreak report data, nine outbreaks were suspected or confirmed to be due to norovirus in November, compared to two in October. We have observed an increase in norovirus activity within the state, though none reported in the Crater Health District to date.

Why is norovirus prevention important?
Norovirus is the leading cause of gastrointestinal illness and of disease outbreaks from contaminated food in the United States. The virus causes your stomach or intestines or both to get inflamed (acute gastroenteritis), leading you to have stomach pain, nausea, and diarrhea and to throw up. Norovirus is a very contagious virus. You can get it from an infected person, contaminated food or water, or by touching contaminated surfaces.

Over 80% of outbreaks occur between November and April. As we enter “norovirus season,” remember that good hand hygiene and routine cleaning of high-touch surfaces are key to preventing the spread of norovirus. Click here for more tips on norovirus prevention.

Please include this widget after the story (widget pulled from CDC norovirus webpage):